The First Department of Oral and Maxillofacial Surgery, Osaka University Dental Hospital, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
Oral Oncol. 2009 Oct;45(10):908-11. doi: 10.1016/j.oraloncology.2009.03.013. Epub 2009 May 19.
The optimal method of management of clinical N0 neck in squamous cell carcinoma of the oral cavity remains controversial. We used decision analysis to determine the current optimal strategy in comparison with observation of the neck and elective neck dissection. A total of 165 previously untreated patients with N0 classification were investigated. Probabilities of each recurrence were calculated and probabilities of being cured in each event were substituted with the 5-year overall survival calculation with Kaplan-Meier method. A sensitivity analysis was performed to determine the optimal threshold for treatment of the N0 neck. The threshold of N0 neck was calculated using the formula with putting the three probabilities of being cured. In this study the threshold was estimated at 44.4%. N0 neck of squamous cell carcinoma of the oral cavity should be observed if the probability of occult metastasis is less than 44.4%. Proper calculation of three probabilities of being cured in each institution will make a decision of the optimal method of clinical N0 neck by using the threshold formula.
口腔鳞状细胞癌临床 N0 颈部的最佳处理方法仍存在争议。我们使用决策分析来确定与颈部观察和选择性颈部清扫术相比，当前的最佳策略。共调查了 165 例未经治疗的 N0 分类患者。计算了每种复发的可能性，并将每种情况下的治愈率的可能性用 Kaplan-Meier 方法的 5 年总生存率计算替换。进行了敏感性分析以确定 N0 颈部治疗的最佳阈值。通过将三种治愈率的概率代入公式，计算出 N0 颈部的阈值。在这项研究中，阈值估计为 44.4%。如果隐匿性转移的概率小于 44.4%，则口腔鳞状细胞癌的 N0 颈部应进行观察。在每个机构中正确计算每种情况下的三种治愈率概率，将使用阈值公式做出最佳临床 N0 颈部处理方法的决策。
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